Medicare Will Not Pay for CT Colonoscopy (Virtual Colonoscopy) as a Screening Test for Colon Cancer

Medicare has issued a proposed decision on whether it will cover/pay for CT colonoscopy, also called virtual colonoscopy or CT colonography, for use as a screening test for colon cancer.  Medicare has proposed that it will not pay for it.  It is asking for comments on its proposed decision.  Medicare concluded that this test was not good enough at finding the smaller polyps that can lead to colon cancer.

CT colonography is performed as follows.  First, the bowel is prepared similar to the preparation used for optical colonoscopy, and stool and fluid tagged with oral contrast.  Then, a CT scan is performed in both supine and prone positions while the patient is fully conscious and produces images of the colon and rectum to assess the presence or absence of structural lesions such as polyps and colon cancer.

Originally, CT colonography produced colon images as a series of individual cross sectional images. With improved computer processing, these images can be combined into a fly-through presentation; this has led to CT colonography mimicking an optical colonoscopy.

For more information, see a summary of Medicare's proposed decision.